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Late results of small untreated abdominal aortic aneurysms

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  • Published:
Annals of Vascular Surgery

Abstract

We report our experience with 73 patients who were initially selected for nonoperative management of an abdominal aortic aneurysm less than 5 cm in diameter. Size of the aneurysm was determined by ultrasound (34); arteriography (16); computerized tomography (17); plain x-ray (4); and magnetic resonance imaging (2). End points of the study were subsequent elective resection, rupture, death from cause other than rupture, or an intact aneurysm followed for a minimum of three years. Overall, 28 (38%) aneurysms were subsequently resected on an elective basis; four (5%) ruptured; 15 (21%) were intact at the time of the patient's death; and 26 (36%) remained intact during follow-up of 3 to 6.5 years. Indications for elective resection were aneurysm enlargement (21); symptoms suggesting impending rupture (3); and improvement in medical condition (4). In the 43 aneurysms initially less than 4 cm diameter, 16 (37%) had elective resection and one (2%) ruptured, and in the 30 that were 4–4.9 cm, 12 (40%) were resected and three (10%) ruptured. The four aneurysms that ruptured had enlarged to greater than 5 cm prior to rupture. We conclude that aneurysms less than 4 cm can be safely followed. Aneurysms 4–4.9 cm should be considered for operation, depending upon the size of the aneurysm, patient's life expectancy, and risk factors for surgery. Any aneurysm that enlarges should be resected, especially if the aneurysm becomes larger than 5 cm in diameter.

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References

  1. PAIROLERO PC. Repair of abdominal aortic aneurysms in high-risk patients.Surg Clin North Am 1989;69:755–763.

    PubMed  Google Scholar 

  2. CRAWFORD ES, STOWE C. True aneurysms of the aorta and iliac arteries. In: MOORE WS (ed).Vascular Surgery: A Comprehensive Review. New York: Grune & Stratton, 1983, 269–773.

    Google Scholar 

  3. CRONENWETT JL, SARGENT SK, WALL MH, et al. Variables that affect the expansion rate and outcome of small abdominal aortic aneurysms.J Vasc Surg 1990;11:260–269.

    PubMed  Google Scholar 

  4. NEVITT MP, BALLARD DJ, HALLETT JW Jr. Prognosis of abdominal aortic aneurysms.N Engl J Med 1989;321:1009–1013.

    PubMed  Google Scholar 

  5. DELIN A, OHLSEN H, SWEDENBORG J. Growth rate of abdominal aortic aneurysms as measured by computed tomography.Br J Surg 1985;72:530–532.

    PubMed  Google Scholar 

  6. COLLIN J. Elective surgery for small abdominal aortic aneurysms.Lancet 1987;1:909.

    Google Scholar 

  7. TREIMAN RL, FORAN RF, LEVIN PM, et al. Improved results in resection of abdominal aortic aneurysms, 1963–1984.Mt Sinai J Med 1986;53:541–544.

    PubMed  Google Scholar 

  8. HERTZER NR, AVELLONE JC, FARRELL CJ, et al. The risk of vascular surgery in a metropolitan community. With observations on surgeon experience and hospital size.J Vasc Surg 1984;1:13–21.

    PubMed  Google Scholar 

  9. DARLING RC, MESSINA CR, BREWSTER DC, et al. Autopsy study of unoperated abdominal aortic aneurysms; the case for early resection.Circulation 1977;56(Suppl 2):161–164.

    Google Scholar 

  10. CRONENWETT JL, MURPHY TF, ZELENOCK GB, et al. Actuarial analysis of variables associated with rupture of small abdominal aortic aneurysms.Surgery 1985;98:472–483.

    PubMed  Google Scholar 

  11. HALLETT JW Jr, BLARD D, CHERRY KJ, et al. Small abdominal aortic aneurysms: a 33 year community experience. Presented before the Forty-third annual meeting of The Society for Vascular Surgery, New York, New York, June 21, 1989.

  12. COLLIN J, ARAUJO L, WALTON J. How fast do very small abdominal aortic aneurysms grow?Eur J Vasc Surg 1989;3:15–17.

    PubMed  Google Scholar 

  13. BERNSTEIN EF, DILLEY RB, GOLDBERGER LE, et al. Growth rates of small abdominal aortic aneurysms.Surgery 1976;80:765–773.

    PubMed  Google Scholar 

  14. STERPETTI AV, SHULTZ RD, FELDHAUS RJ, et al. Factors influencing enlargement rate of small abdominal aortic aneurysms.J Surg Res 1987;43:211–219.

    PubMed  Google Scholar 

  15. LITTOOY FN, STEFFAN G, GREISLER HP, et al. Use of sequential ultrasonography to manage abdominal aortic aneurysms.Arch Surg 1989;124:419–421.

    PubMed  Google Scholar 

  16. Statistical abstracts of the United States, 106th edition. Washington, DC: US Department of Commerce, Bureau of the Census, 1986, p. 69.

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Author information

Author notes

  1. Richard L. Treiman MD

    Present address: , 8631 West Third Street, 90048, Los Angeles, California

Authors and Affiliations

  1. Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California

    Richard L. Treiman MD, Susan L. Hartunian MD, David V. Cossman MD, Robert F. Foran MD, J. Louis Cohen MD, Phillip M. Levin MD & Willis H. Wagner MD

Authors
  1. Richard L. Treiman MD
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  2. Susan L. Hartunian MD
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  3. David V. Cossman MD
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  4. Robert F. Foran MD
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  5. J. Louis Cohen MD
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  6. Phillip M. Levin MD
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  7. Willis H. Wagner MD
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Treiman, R.L., Hartunian, S.L., Cossman, D.V. et al. Late results of small untreated abdominal aortic aneurysms. Annals of Vascular Surgery 5, 359–362 (1991). https://doi.org/10.1007/BF02015297

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  • DOI: https://doi.org/10.1007/BF02015297

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